CBS 2019
CBSMD教育中心
中 文

Other Relevant Articles

Abstract

Recommended Article

Healthy Behavior, Risk Factor Control, and Survival in the COURAGE Trial Effect of a Home-Based Wearable Continuous ECG Monitoring Patch on Detection of Undiagnosed Atrial Fibrillation The mSToPS Randomized Clinical Trial Biological Phenotypes of Heart Failure With Preserved Ejection Fraction Predicting lifetime risk for developing atherosclerotic cardiovascular disease in Chinese population: the China-PAR project Coronary Angiography after Cardiac Arrest without ST-Segment Elevation Update in the Percutaneous Management of Coronary Chronic Total Occlusions Impact of Oxidative Stress on the Heart and Vasculature: Part 2 of a 3-Part Series Screening for Cardiovascular Disease Risk With Electrocardiography: US Preventive Services Task Force Recommendation Statement

Review ArticleVolume 72, Issue 25, December 2018

JOURNAL:J Am Coll Cardiol. Article Link

Clinician’s Guide to Reducing Inflammation to Reduce Atherothrombotic Risk

PM Ridker Keywords: atherosclerosis; canakinumab; CANTOS; inflammation; interleukin-1

ABSTRACT


Life-threatening cardiovascular events occur despite control of conventional risk factors. Inflammation, as measured by high-sensitivity C-reactive protein (hsCRP) concentration, is associated with future vascular events in both primary and secondary prevention, independent of usual risk markers. Statins are powerful lipid-lowering agents with clinically relevant anti-inflammatory effects. Recent data support targeting the interleukin (IL)-1-to-IL-6-to-CRP signaling pathway as an adjunctive method for atheroprotection. The CANTOS (Canakinumab Anti-inflammatory Thrombosis Outcomes Study) trial showed that reducing inflammation through IL-1β inhibition significantly reduced vascular risk, beyond that achievable with lipid lowering. CANTOS further demonstrated a 31% reduction in cardiovascular mortality and all-cause mortality among patients treated with canakinumab who achieved the largest reductions in hsCRP, as well as efficacy in high-risk patients with chronic kidney disease and diabetes. This review outlines the clinical implications of CANTOS for patients with “residual inflammatory risk,” the potential benefits and risks associated with anti-inflammatory therapy, and the importance of CANTOS for future drug development.